Month: October 2016

Acupuncture for preventing migraine attacks

Bottom line

The available evidence suggests that a course of acupuncture consisting of at least six treatment sessions can be a valuable option for people with migraine.

Background

Individuals with migraine have repeated attacks of severe headache, usually just on one side and often with vomiting. Acupuncture is a therapy in which thin needles are inserted into the skin at particular points. It originated in China, and is now used in many countries to treat people with migraine. We evaluated whether acupuncture reduces the number of episodes of migraine. We looked at the number of people in whom the number of migraine days per month was reduced by half or more than half.

Key results

For this update, we reviewed 22 trials with 4985 people, published up to January 2016. We omitted five trials from the original review because they included people who had had migraine for less than 12 months. We included five new trials in this update.

In four trials, acupuncture added to usual care or treatment of migraine on onset only (usually with pain-killers) resulted in 41 in 100 people having the frequency of headaches at least halved, compared to 17 of 100 people given usual care only.

In 15 trials, acupuncture was compared with ‘fake’ acupuncture, where needles are inserted at incorrect points or do not penetrate the skin. The frequency of headaches halved in 50 of 100 people receiving true acupuncture, compared with 41 of 100 people receiving ‘fake’ acupuncture. The results were dominated by three good quality large trials (with about 1200 people) showing that the effect of true acupuncture was still present after six months. There were no differences in the number of side effects of real and ‘fake’ acupuncture, or the numbers dropping out because of side effects.

In five trials, acupuncture was compared to a drug proven to reduce the frequency of migraine attacks, but only three trials provided useful information. At three months, headache frequency halved in 57 of 100 people receiving acupuncture, compared with 46 of 100 people taking the drug. After six months, headache frequency halved in 59 of 100 people receiving acupuncture, compared with 54 of 100 people taking the drug. People receiving acupuncture reported side effects less often than people receiving drugs, and were less likely to drop out of the trial.

Our findings about the number of days with migraine per month can be summarized as follows. If people have six days with migraine per month on average before starting treatment, this would be reduced to five days in people receiving only usual care, to four days in those receiving fake acupuncture or a prophylactic drug, and to three and a half days in those receiving true acupuncture.

Acupuncture: Why It Works

More than 3 million Americans receive acupuncture each year, and its use is increasing.1 While there are a variety of acupuncture techniques, those typically used in the U.S. incorporate traditions from China, Japan and Korea and involve penetrating your skin with a thin needle at certain points on your body.

The needle is then stimulated by hand or electrically.2 Acupuncture has been in use for thousands of years around the globe, and it has withstood the test of time because it works to safely relieve many common health complaints.

How it works has remained largely a mystery, but last year researchers revealed a biochemical reaction that may be responsible for some of acupuncture’s beneficial effects.

Scientists Reveal How Acupuncture Reduces Inflammation and Pain

An animal study looking into the effects of acupuncture on muscle inflammation revealed that manual acupuncture downregulates (or turns off) pro-inflammatory cells known as M1 macrophages. At the same time, it upregulates (or activates) anti-inflammatory M2 macrophages, thereby reducing pain and swelling.3

This is an effective strategy because M2 macrophages are a source of anti-inflammatory interleukin-10 (IL-10), a cytokine involved in immune response. It’s thought that upregulating M2 macrophages leads to an increase in IL-10, which subsequently helps relieve pain and inflammation. The Epoch Times reported:4

M1 macrophage downregulation and M2 macrophage upregulation triggered by acupuncture was positively associated with reductions in muscle pain and inflammation.”

It’s likely that acupuncture works via a variety of mechanisms. In 2010, for instance, it was found that acupuncture activates pain-suppressing receptors and increased the concentration of the neurotransmitter adenosine in local tissues.5

Adenosine slows down your brain’s activity and induces sleepiness. According to a Nature Neuroscience press release:6

“ … [T]he authors propose a model whereby the minor tissue injury caused by rotated needles triggers adenosine release, which, if close enough to pain-transmitting nerves, can lead to the suppression of local pain.”

Acupuncture Influences Your Body on Multiple Levels

With documented use dating back more than 2,500 years, acupuncture is based on the premise that there are more than 2,000 acupuncture points in the human body, which are connected by bioenergetic pathways known as meridians.

According to traditional medicine, it is through these pathways that Qi, or energy, flows, and when the pathway is blocked the disruptions can lead to imbalances and chronic disease.

Acupuncture is proven to impact a number of chronic health conditions, and it may work, in part, by stimulating your central nervous system to release natural chemicals that alter bodily systems, pain and other biological processes. Evidence suggests that acupuncture may also work by:7

Stimulating the conduction of electromagnetic signals, which may release immune system cells or pain-killing chemicals

Activation of your body’s natural opioid system, which may help reduce pain or induce sleep